From Health Plan Week - “The insurance model is not keeping up with the science.”
That’s according to Rep. Brian Higgins (D-N.Y.), a member of the House Cancer Caucus and sponsor of H.R. 2739, the Cancer Drug Coverage Parity Act of 2015, which would require insurers to cover novel oral cancer therapies under terms equally favorable to those of traditional intravenous chemotherapy treatments.Read more

From Health Plan Week - The field of telemedicine is growing, as heavy-hitters UnitedHealth Group and Walgreens Boots Alliance, Inc., expand their telehealth programs, and major vendors Teladoc and American Well clash in court. But barriers to access still exist, as issues with state medical licenses linger and state medical boards hesitate to greenlight a tool with the potential to threaten the physician-patient relationship.Read more

From The AIS Report on Blue Cross and Blue Shield Plans - In a recent Evercore ISI webinar, Howard Wild, vice president of generic strategies for pharmacy benefit manager (PBM) MedImpact, Inc., said the generic inflation rate has been “astronomical.…We’ve seen some drugs go up in excess of 2,000%,” he said, adding that price increases exceeding 100% “are not unusual.” And while the inflation eased up a bit at the beginning of 2015, it started going up again in April, although to…Read more

Health Plan Business Blog

As Cleveland Clinic has transitioned to population health management, one area of focus has been improved access to care. “Access is actually getting to see the care provider. We’ve put a lot of effort on this over the last couple of years. [Patients] should be able to see a physician anytime,...

Some notable advocates for alternative payment models are mostly supportive of the CMS effort announced earlier in July to try out a bundled payment program for knee and hip replacements in the Medicare program in selected areas of the country. The program CMS proposed, and which will not be made...

Just in case you missed it … the Supreme Court on June 25 determined federal premium subsidies are available in all states, whether through a state-based exchange (SBE) or via the federally operated HealthCare.gov. With federal subsidies secure, governors in Pennsylvania and Delaware quickly...